OBJECTIVETo evaluate the clinical effects of closed reduction and percutaneous pinning in treatment of "irreducible" supracondylar humeral fractures in children.

METHODSSeventy-six consecutive children of Gartland III supracondylar humeral fractures treated in the Department of Pediatric Orthopedics of the Third Affiliated Hospital of Southern Medical University from July 2011 to July 2013 were analyzed retrospectively, of which 69 were extension type fractures and 7 were flexion type. There were 52 male and 24 female patients with an average age of 6.5 years (range 1.6 to 13 years). The average time from injury to operation was 6.8 hours (range 4 to 48 hours). The mechanism of injury included 15 cases of high falling, and 61 cases of falling to the ground while walking or running. All cases were treated via closed reduction and percutaneous pinning. The radiographs were assessed every follow-up, including the healing and function of the elbow.

RESULTSNo major complications such as osteofascial compartment syndrome or neurovascular injuries occurred in these patients. Two cases with neurological injuries before the surgery were recovered fully after the surgery. According to Flynn criteria at follow-up evolution, 71 cases were excellent, and 5 were good.

CONCLUSIONSFor the treatment of Gartland type III supracondylar humerus fractures in children, including "irreducible" supracondylar fractures of the humerus, closed reduction and percutaneous pinning is a safe and minimally invasive procedure, by which good fractures reductions and postoperative functions of the elbow can be achieved.

Adolescent ; Child ; Child, Preschool ; Elbow ; Female ; Fracture Fixation, Intramedullary ; Humans ; Humeral Fractures ; surgery ; Humerus ; pathology ; Infant ; Male ; Retrospective Studies